Gary Robert Beaumont, CRNA

Key facts

NPI

1376541722

Entity type

Individual (NPI type 1)

Primary specialty

Certified Registered Nurse Anesthetist 367500000X

License

4072 (SC)

Practice address

3000 Saint Matthews Rd
Orangeburg, SC 29118-1442

Phone

(803) 395-2200

NPI assigned

Jul 11, 2005

Sex

Male

Sole proprietor

No

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mid-Cumberland Anesthesia Certified Registered Nurse Anesthetist · Cynthiana, KY · NPI 1235449224
  NPD (past) NURSE ANESTHETIST, CERTIFIED REGISTERED
• Mooresville Hospital Management Associates LLC General Acute Care Hospital · Mooresville, NC · NPI 1073568754
  NPD (past)
• Mooresville Hospital Management Associates, LLC Certified Registered Nurse Anesthetist · Mooresville, NC · NPI 1548399827
  NPD (past) NURSE ANESTHETIST, CERTIFIED REGISTERED
• Resource Anesthesia Lakeway, Inc. Specialist · Lenoir, NC · NPI 1144573015
  NPD (past)
• WRMC Hospital Operating Corporation Hospitalist Physician · North Wilkesboro, NC · NPI 1093737082
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

HHS exclusion list flag

The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Certified Registered Nurse

State licenses

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 27, 2011.

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1376541722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1245",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291161245",
            "telephone_number": "803-395-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 SAINT MATTHEWS RD",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291181442",
            "telephone_number": "803-395-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUMONT",
        "first_name": "GARY",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "123746",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "APN10192",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "123746",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "6045A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "4072",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN605111",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "77137",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "74400805",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2825",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "4274202",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000685047",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

• Kaitlyn Beach
• Lateisha Chanette Beard
• Noah Wesley Bearden, DC
• Touray K Beaton Jr.
• Anetra Beaufort, MA,CFY-SLP
• Behavioral Diagnostics, LLC
• Edit Beli, LPC
• Diane Bell
• Marsha A Bellinger-Shields, LMSW
• Benchmark Healthcare Service LLC

All providers in Orangeburg, SC · Certified Registered Nurse Anesthetist in South Carolina